Data from the foundation trust watchdog Monitor show that 40% of more than 2,500 patients surveyed this year were offered a choice of hospital or clinic for a first outpatient appointment, compared with 38% of respondents last year.
Around half of patients were aware of their right to choose where to receive treatment, but awareness has declined since last year, from 51% of patients to 47%.
A total of 52% in rural areas were aware, compared with 46% in urban areas. Patients in rural areas were marginally more lkely to be offered a choice, Monitor's survey found.
The data show that 64% of people aged 18 to 25 were not offered a choice. Among patients who were offered a choice, nine out of 10 said they had enough information to do so.
GP referral choice
GPC deputy chairman Dr Richard Vautrey said: 'Encouraging discussion and offering choice is an important part of how services are delivered in general practice. However, while GPs are working hard to deliver a record number of appointments to the public, they are under incredible pressure from rising demand, especially from an ageing population.
'Many of these cases are complex as older patients often have several conditions that leave limited time for discussion about referrals, not least as many patients still prefer to go to their local hospital. Some CCGs are also restricting GP referrals to cut costs which further constrains the options available for both GPs and the public.
'To really open up choice we need longer consultations. A recent BMA survey of 15,560 GPs, found that only one in ten felt that current appointments were long enough. We also need a properly funded and supported GP service that gives doctors the capacity and ability to meaningfully ensure patients get a say over their treatment options.'
Catherine Davies, executive director of co-operation and competition at Monitor, said: 'We think it’s only right that patients are in the driving seat when it comes to making decisions that affect their health, and this shows us that GPs are continuing to have helpful conversations with patients and offering more choice. But there is still more the NHS can do to make sure patients are aware of their legal right to choose and are able to make a choice.'